Circumcision ring, men risk tetanus infection

Unimmunised men who undergo circumcision using prepex device (popularly known as Ring), risk tetanus infection through wounds on their organs, it has been learnt.

It is against this backdrop that the Government has made available more tetanus vaccines for men seeking to undergo the procedure and a full scale national vaccination is expected to start next month.

The latest revelation in health studies has seen the Government scaling down the use of the device for circumcising men, demanding to know if the patient is immunised against tetanus or not.

Studies from other countries revealed that unimmunised men were at high risk of tetanus infection after that form of circumcision.

Tetanus is a serious infection caused by Clostridium tetani and this bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles.

The infection can cause severe muscle spasms, serious breathing difficulties and can ultimately be fatal.

One can get tetanus infection when the spores enter the body through an injury or wound and the spores release bacteria that spread in the body.

Head of Aids and Tuberculosis Unit in the Ministry of Health and Child Care, Dr Owen Mugurungi, confirmed the development.

He said men who wanted to be circumcised with the device should provide proof of adult immunisation against tetanus.

Dr Mugurungi said this was in line with the latest World Health Organisation (WHO) guidelines on male circumcision.

"The Voluntary Medical Male Circumcision (VMMC) programme continues to review and improve quality of services from time to time for all clients as required.

"New WHO guidelines recommend that all men undergoing VMMC with the prepex device should have been vaccinated against tetanus as adults. We are currently offering circumcision with the prepex device to those that can provide proof of vaccination," said Dr Mugurungi.

He said Zimbabwe had a low tetanus burden, recording less than one case of neonatal tetanus per 1 000 live births and has an efficacious immunisation programme.

He said for the safety of the clients, the country recommended that all men undergoing any form of circumcision must provide evidence of tetanus immunisation.

"Tetanus vaccination is a basic service that has always been provided to different categories of clients such as pregnant women, children and patients who have wounds.

"Its inclusion in the VMMC programme is part of the reinforcement of the basic services for this group of clients and does not amount to a new procedure," said Dr Mugurungi.

He said under the new recommendations, men intending to undergo circumcision must receive two doses of tetanus toxoid containing vaccine (TTCV) before they could have the procedure done.

He said men opting for the surgical method can have the vaccine on the day of the circumcision.

Dr Mugurungi said some men have already shown interest in using the prepex device even with the vaccination requirement as they have seen the benefits of tetanus vaccination in the long term.

He said given this background, the country had already mobilised resources for national rollout of the tetanus vaccination in adult males.

"The country has mobilised enough resources for the tetanus vaccine requirements and the full-scale vaccination is expected to commence between May and June 2017. Thus, it is expected that more men will continue to be circumcised using the device method once all the vaccines are in place," said Dr Mugurungi.

To date, over 915 000 men have been circumcised since the inception of the programme.

Circumcision is believed to reduce chances of HIV acquisition from an infected partner by at least 60 percent.